Provider Demographics
NPI:1013069251
Name:SUBJECT, STEVEN A (DDS, FACD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:SUBJECT
Suffix:
Gender:M
Credentials:DDS, FACD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 S PATTERSON AVE
Mailing Address - Street 2:BLDG. B SUITE 208
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2055
Mailing Address - Country:US
Mailing Address - Phone:805-964-2110
Mailing Address - Fax:805-964-6381
Practice Address - Street 1:122 S PATTERSON AVE
Practice Address - Street 2:BLDG. B SUITE 208
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2055
Practice Address - Country:US
Practice Address - Phone:805-964-2110
Practice Address - Fax:805-964-6381
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA318671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice